摘要
目的探讨境外、国内输入及本地感染的新型冠状病毒肺炎(COVID-19)患者CT征像及临床特点。方法收集调查兰州大学第一医院(12例)、甘肃省人民医院(30例)和兰州市肺科医院(31例)2020年1月—2020年3月住院治疗共73例COVID-19患者的病例资料,分析3组患者的人口学资料、临床特征及不同病情演变期胸部CT病灶分布、变化、面积及密度值等特点与差异。结果境外输入患者临床表现以咽痛、咳嗽为主,分别占46.3%(17/39)和25.6(10/39)。国内输入患者以发热为主,占58.3%(7/12),本地感染以乏力为主,占36.4%(4/11)。境外输入患者的完全吸收率、发病初期无影像学改变率和单侧多发病灶发生率分别为100.0%、54.5%和22.7%,显著高于国内输入和本地感染患者73.3%和71.4%、6.7%和28.6%、6.7%和7.1%。境外输入患者的加重时间、条索病灶率和双侧多发/广泛病灶发生率分别为(4.69±1.40)d、0和9.1%,显著低于国内输入和本地感染患者(6.36±2.16)d和(8.40±3.71)d、26.7%和28.6%、73.3%和57.1%(均P<0.01)。3组患者发病初期、好转吸收期病灶面积以及发病初期CT高密度值、差值比较,差异均有统计学意义(P<0.05);病变加重期CT低密度值、差值比较,差异有统计学意义(P<0.05);好转吸收期差值比较,差异有统计学意义(P<0.05)。结论境外输入患者病情较轻,病灶面积较小,密度较均一,病灶可完全吸收,可能与境外输入患者多为青壮年、确诊早或病毒遗传变异有关;国内输入及本地感染患者病情较重,病灶面积大,密度不均一,病情痊愈可留有条索样病灶;因此,对于不同地源的COVID-19患者,应结合临床表现和胸部影像学等进行综合分析。
Objective To investigate the CT features and clinical features of coronavirus disease 2019(COVID-19)patients imported from abroad,China and infected locally.Methods The case data of 73 COVID-19 patients who were hospitalized in Lanzhou University First Hospital(12 cases),Gansu Provincial People's Hospital(30 cases)and Lanzhou Pulmonary Hospital(31 cases)from January 2020 to March 2020 were retrospectively collected.Demographic data,clinical characteristics,distribution,changes,area and density values of chest CT lesions in different disease evolution stages were compared and analyzed among the three groups.Results The main clinical manifestations of the imported patients from abroad(44 cases)were sore throat(46.3%,17/39)and cough(25.6%,10/39),fever(58.3%,7/12)in the domestic imported patients,and fatigue(36.4%)in local infections.Evolution of chest CT signs,the number of cases with complete absorption,no imaging changes at the beginning of the disease,and unilateral multiple lesions in imported patients(100.0%,54.5%,1022.7%)were significantly higher than those in imported domestic and locally infected patients 73.3%and 71.4%,6.7%and 428.6%,6.7%and 7.1%;The aggravation time,cord lesions,bilateral multiple/extensive lesions[(4.69±1.40)d,0,9.1%]were significantly lower than those of domestic imported and local infected patients[(6.36±2.16)d and(8.40±3.71)d,26.7%and 28.6%,73.3%and 57.1%](all P<0.01).There was statistical significance in the area of the lesions in the early stage of disease and the absorption stage of improvement among the imported patients from abroad,imported patients from China and local infected patients(P<0.05).There were statistically significant differences in CT high-density value and difference value at the early stage of onset among the three groups(P<0.05).The difference between CT low density value and difference value in the exacerbation stage was statistically significant(P<0.05).The difference of absorption period was statistically significant(P<0.05).Conclusion The disease of the im
作者
吴吉荣
张艺
刘永琦
王燕
冉燕
王童
庄辛
董静
马军
曾晓丽
包海荣
刘晓菊
WU Ji-rong;ZHANG Yi;LIU Yong-qi;WANG Yan;RAN Yan;WANG Tong;ZHUANG Xin;DONG Jing;MA jun;ZENG Xiao-li;BAO Hai-rong;LIU Xiao-ju(Department of Geriatric Respiration,The First Hospital of Lanzhou University,Lanzhou,Gansu 730000,China;Key Laboratory of Molecular Medicine and Prevention and Treatment of Major Diseases of Gansu Province,Gansu University of Traditional Chinese Medicine,Lanzhou,Gansu 730000,China;Department of Infection Control,Gansu Provincial People's Hospital,Lanzhou,Gansu 730000,China;Department of Radiology,Lanzhou Pulmonary Hospital,Lanzhou,Gansu 730000,China;Department of Respiratory Medicine,Guanghe County Hospital,Guanghe Gansu 731300,China)
出处
《中国热带医学》
CAS
2021年第8期774-778,共5页
China Tropical Medicine
基金
甘肃省重大疾病分子医学与中医药防治研究重点实验室新型冠状病毒防治研究专项开放基金(No.FZYX20-5)
甘肃重点研发计划项目(No.20YF2FA013)。
